{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:16:46Z","timestamp":1791191806246,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2005,10,25]],"date-time":"2005-10-25T00:00:00Z","timestamp":1130198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2005,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Aims\u2003<\/jats:bold>\n                    To track the effect of the French harm reduction programme targeted at intravenous drug users (IDUs) and associated health outcomes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Material\u2003<\/jats:bold>\n                    Since 1996, we have collected monthly sales of sterile syringes and substitution treatments (buprenorphine high dosage and methadone) sold to IDUs in the 23\u2003000 pharmacies in France and collated these figures in a single data base (SIAMOIS). To this data base we have also added the number of syringes distributed through community associations, as well as methadone treatments prescribed in public drug dependence clinics.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods\u2003<\/jats:bold>\n                    For the period 1996\u20132003 we analysed syringe sales and prescribed substitution treatments as indicators of access to harm reduction services. We compared variations of these figures over time with trends in health outcome indicators [annual number of fatal overdoses, hepatitis C virus (HCV) and human immunodeficiency virus (HIV) prevalence among intravenous drug users], risk behaviour indicators (rate of syringe sharing or rate of syringe re\u2010use) and legal indicators (heroin and cocaine use\u2010related arrests).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Findings\u2003<\/jats:bold>\n                    The number of sterile syringes sold or distributed to IDUs increased from 1996 to 1999 (+\u200321%) and then decreased dramatically from 1999 to 2003 (\u221240%). In 2003, we estimated that more than 100\u2003000 drug users used substitution treatments. Between 1996 and 2003, a decrease in syringe sharing and syringe re\u2010use was observed, HIV prevalence among IDUs decreased from 40% to 20% and HCV prevalence remained high (60\u201370%). From 1996 to 2003, arrests due to heroin use declined (from 17\u2003328 to 4025) and deaths due to overdoses also decreased (from 465 to 89), whereas arrests for cocaine use increased from 1184 to 2511.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion\u2003<\/jats:bold>\n                    Our results indicate that, since 1996 in France, IDUs have had greatly improved access to sterile syringes and substitution treatments. The decrease in syringe sharing and re\u2010use practices and of HIV prevalence during the same time period indicates that the harm reduction policy implemented in France has had a positive impact. However, because of the persistent sharing and re\u2010use of syringes and a remaining high HCV prevalence in IDUs, efforts to facilitate access to sterile syringes must continue, and targeting of at\u2010risk groups must be improved. Behavioural surveys associated with HIV and HCV seroprevalence data are needed to further assess prevention of blood\u2010borne infections among IDUs in France.\n                  <\/jats:p>","DOI":"10.1111\/j.1360-0443.2005.01271.x","type":"journal-article","created":{"date-parts":[[2005,10,25]],"date-time":"2005-10-25T07:15:38Z","timestamp":1130224538000},"page":"1690-1700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["Harm reduction interventions, behaviours and associated health outcomes in France, 1996\u20132003"],"prefix":"10.1111","volume":"100","author":[{"given":"Julien","family":"Emmanuelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Claude","family":"Desenclos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,10,25]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Bello P. Y.&Toufik A.(2002)Ph\u00e9nom\u00e8nes \u00e9mergents lies \u00e0 l\u2019usage de drogues en France en 2001 [Emerging phenomena link to the use of drugs in France in 2001]. Paris:Observatoire Fran\u00e7ais des Drogues et des Toxicomanies. 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Results of the SPESUB study","volume":"48","author":"Duburcq A.","year":"2000","journal-title":"Revue D\u2019\u00e9pid\u00e9miologie et de Sant\u00e9 Publique"},{"key":"e_1_2_5_9_1","unstructured":"Emmanuelli J.(2001)Contribution \u00e0 l\u2019\u00e9valuation de la politique de r\u00e9duction des risques: le syst\u00e8me SIAMOIS.Bulletin Epid\u00e9miologique Hebdomadaire 4 21\u201323. Available at:http:\/\/www.invs.sante.fr\/beh\/2001\/05. Accessed 14 February 2001."},{"key":"e_1_2_5_10_1","unstructured":"Emmanuelli J. Jauffret\u2010Roustide M.&Barin F.(2003)L\u2019\u00e9pid\u00e9mie d\u2019h\u00e9patite c chez les usagers de drogues.Bulletin Epid\u00e9miologique Hebdomadaire 16\u201317 97\u201399. Available at:http:\/\/www.invs.sante.fr\/beh\/2003\/16_17. 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Pillonel J. Pinget R. David D. Couturier S.et al.(2004)Premiers r\u00e9sultants du noveau dispositif de surveillance de l\u2019infection \u00e0 VIH et situation du sida au 30 septembre 2003 [Preliminary results of mandatory reporting of AIDS diagnosis at 30 September 2003].Bulletin Epid\u00e9miologique Hebdomadaire 24\/25 102\u2013110. Available fromhttp:\/\/www.invs.sante.fr\/beh\/2004\/24_25. [accessed 26 August 2005]."},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880400247X"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00335.x"},{"key":"e_1_2_5_24_1","unstructured":"Observatoire Fran\u00e7ais des Drogues et des Toxicomanies (OFDT) (2003) Drugs and drug addictions\u2014indicators and trends 2002. 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